radiographic lung patterns

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5 Terms

1
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alveolar pattern

  • soft tissue opaque

  • border effacement of pulmonary vessels, other structures

    • poor visualization of heart margins

  • air bronchograms “trees in the fog”

    • red arrows

  • ± lobar sign (blue arrow)

air in alveoli is replaced by fluid or not replaced (atelectasis)

<ul><li><p>soft tissue opaque</p></li><li><p><strong><u>border effacement</u></strong> of pulmonary vessels, other structures</p><ul><li><p>poor visualization of heart margins</p></li></ul></li><li><p><strong><u>air bronchograms</u></strong> “trees in the fog”</p><ul><li><p>red arrows</p></li></ul></li><li><p>± lobar sign (blue arrow)</p></li></ul><p>air in alveoli is replaced by fluid or not replaced (atelectasis)</p>
2
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unstructured interstitial pattern

regional, diffuse, hazy

  • increased opacity of interstitial tissue but pulmonary vessels still visible

    • cellular, fluid, or fibrotic change

  • mimicked by poor rad quality, expiration, obesity


<p><strong>regional, diffuse, hazy</strong></p><ul><li><p>increased opacity of interstitial tissue but <strong>pulmonary vessels still visible</strong></p><ul><li><p>cellular, fluid, or fibrotic change</p></li></ul></li><li><p>mimicked by poor rad quality, expiration, obesity</p></li></ul><p></p>
3
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structured interstitial pattern

  • nodules, masses, miliary

    • nodule must be >3 mm diameter to be resolved from surrounding lung tissue

  • can be solid or cavitated (gas-filled)


<ul><li><p>nodules, masses, miliary</p><ul><li><p>nodule must be &gt;3 mm diameter to be resolved from surrounding lung tissue</p></li></ul></li><li><p>can be solid or cavitated (gas-filled)</p></li></ul><p></p>
4
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bronchial pattern

  • increased visibility of bronchial walls

    • thickening or mineralization of small airways

  • seen as “donuts” (cross-section) or “tram lines” (longitudinally)


<ul><li><p><strong>increased visibility of bronchial walls</strong></p><ul><li><p>thickening or mineralization of small airways</p></li></ul></li><li><p>seen as “donuts” (cross-section) or “tram lines” (longitudinally)</p></li></ul><p></p>
5
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vascular pattern

  • dilation, narrowing, or altered course of pulmonary vessels

    • loss of normal tapering

  • most often associated with cardiac disease

  • reduced vascular pattern with hypovolemia or shock

    • may appear as hyperlucent lungs


<ul><li><p><strong>dilation, narrowing, or altered course of pulmonary vessels</strong></p><ul><li><p>loss of normal tapering</p></li></ul></li><li><p>most often associated with cardiac disease</p></li><li><p>reduced vascular pattern with hypovolemia or shock</p><ul><li><p>may appear as hyperlucent lungs</p></li></ul></li></ul><p></p>